Embarking On A Gluten Free/Dairy Free Elimination Diet
by Dr. Louise Gagné

An elimination diet is considered the best way to explore food intolerances that may be negatively affecting your health. Two of the most frequently experienced intolerances are to gluten and dairy.

If you decide to start an elimination diet for gluten and dairy, do so at a time when you can prepare most of your meals from scratch, and bring a lunch with you to work or school. Avoid doing an elimination diet at Christmas, during other holidays, or while travelling. Be sure to work with a qualified healthcare practitioner.

It is recommended to be screened for celiac disease before you begin an elimination diet. This is a simple blood test that your doctor can order.

Start by stocking up on the foods you will be able to eat on this diet. Foods to have on hand include rice (all kinds), gluten free bread, rice crackers, rice pasta, 100% corn tortillas, vegan cheeses (make sure these do not contain casein, which is milk protein), almond/hemp/coconut/soy milk, and gluten free breakfast cereals. For baking, use a gluten free flour mix. Remember to read labels.

You will be able to continue to eat all nuts and seeds; all fruits and vegetables; grains such as rice, millet, corn, and quinoa; beans; soy products; eggs, fish, and meat.

PHASE 1: During the first 3–4 week time period, you will need to completely avoid gluten and dairy containing foods. (Check the “allowed” and “avoid” food lists later in this article.) Read labels carefully and particularly if you are using condiments or other prepackaged foods. Try to eat most of your meals at home, or bring food that you have prepared with you. Restaurant meals often contain ingredients that servers and even cooks are not aware of. If you do go to a restaurant, order something simple (e.g. plain grilled fish, plain rice, or a baked potato, steamed vegetables). Avoid sauces, soups, and anything breaded or deep fried. Remember that some restaurants cook rice in a broth that may contain gluten, so ask your server to check with the kitchen staff about ingredients. To get useful information, you will need to eliminate dairy and gluten completely, 100%.

PHASE 2: During the reintroduction phase, take notice of any negative symptoms you may experience such as abdominal cramps, diarrhea, bloating, congestion, coughing, sneezing, headache, body aches, skin rashes, etc.

If a new food you introduce causes negative symptoms, stop eating the food and go back to the diet you were following previously until you feel well again. Then go on with the reintroduction plan. Don’t reintroduce a new food until you have recovered from any negative reaction to a previously introduced food.

Reintroduce dairy and gluten containing foods using the following protocol:

Reintroduce gluten by eating foods such as wheat pasta, breads, wraps, and bagels. Eat these gluten containing foods at least twice a day for one week. If there is a clear negative reaction, stop the gluten containing foods and return to your previous diet. If you continue to feel well and have not noticed any negative reaction to gluten, add in dairy products in these three stages:

a) Introduce “lactose free” A2 casein dairy products. Look for cheeses (e.g. goat’s or sheep’s milk cheddar cheese) that state they are lactose free. Try these for 3-4 days unless there is a negative reaction.
If you continue to feel well, go on to lactose containing A2 dairy.

b) Introduce lactose containing A2 dairy products by drinking some plain liquid goat’s milk (available at health food stores, or the market from Red Barn Dairy), or use liquid goat’s milk on breakfast cereal, or in soup. Have at least two glasses per day. Continue this for 3-4 days unless there is a negative reaction.

c) If A2 liquid milk products are well tolerated, then try introducing lactose free A1 casein milk products (such as cheddar cheese made with cow’s milk). Try this for 3-4 days unless you have a clear negative reaction, in which case stop this food.

Keep a special notebook where you will record how you are feeling, both during the initial first phase of the diet, and as you gradually add new foods.

ALLOWED FOODS ON THIS ELIMINATION DIET

Grains:
All gluten free breads, cereals, noodles, or whole grains, for example, rice (all types), buckwheat, millet, tapioca, sorghum, amaranth, quinoa, wild rice, corn.

Dairy substitutes:
Rice milk, hemp milk, coconut milk, almond milk, soy milk, etc. Read labels to ensure these are gluten free.

“AVOID” FOODS

Grains:
All gluten containing grains and flours: wheat, rye, barley, spelt, kamut, triticale, oats, couscous, bulgur, egg noodles, most breakfast cereals, and pasta. NOTE: Most soy sauce contains gluten, however gluten free options are available.

Dairy products:
Milk, cheese, yogurt, ice cream, butter, sour cream, buttermilk, kefir, whey, anything containing casein

SUPPLEMENTS: Check that the supplements you are taking do not contain gluten or dairy.

MEDICATIONS: Do not stop any of your prescription medications while doing the elimination diet. However, it is advisable to check with your pharmacist to ensure your medications do not contain gluten or dairy.

An elimination diet takes a lot of care, but can be very rewarding. Identifying and eliminating foods you are intolerant to can improve how you feel, reduce inflammation, improve digestion, and help manage chronic disease.

Cooking Gluten Free Grains

Brown basmati rice: Mix one cup of rice with 2 cups of cold water. Bring to a boil and cover, simmering until all the water is absorbed.

Millet: Mix one cup of millet with 2 and ¼ cups cold water. Bring to a boil and simmer, covered, on low heat until all water is gone, plus steam another 10–15 minutes with the lid on, on very low heat.

Quinoa: For fluffy consistency, mix one cup quinoa with 1¼ cups water. Bring to a boil and simmer, covered, until all water is gone.

For porridge: mix 1 cup of quinoa or quinoa flakes with 2 cups water, simmer until thick.

Rice noodles: For Asian style rice thread noodles, soak noodles in cold water for at least one hour. Meanwhile, bring a large pot of water to a boil. Plunge the presoaked noodles into the boiling water for about one minute, then drain and rinse with cold water.

Rice pasta: Bring a large pot of water to a boil. Drop dry noodles into boiling water and cook for about 9–11 minutes. Drain and rinse with cold water. Drizzle with a small amount of olive oil.

Gluten free flour mix to use for pancakes, waffles, or muffins:
1 cup brown rice flour
1 cup buckwheat flour
1 cup finely ground flax (Grind flax in a coffee grinder or buy already ground. Keep ground flax in a tightly sealed bag in the freezer or grind fresh just before using, since it spoils quickly.)

Keep this mixture in a jar in the fridge and use in whatever amount is called for in the recipe for muffins, pancakes, etc.

To thicken soups or sauces, use tapioca flour or arrowroot flour. Pour ½ cup of the broth into a bowl and whisk with a tablespoon of tapioca or arrowroot flour. Then add this mixture back to the broth and stir well.

These instructions were written by Dr. Louise Gagné before she passed away in April of 2023. She practiced medicine in Saskatoon for over 35 years and completed a Fellowship in Integrative Medicine at the University of Arizona with Dr. Andrew Weil.  She taught nutrition and integrative medicine at the University of Saskatchewan’s College of Medicine for 15 years.

This information is for general education and is not meant to be used by a patient alone. Please work with a qualified healthcare practitioner to use this guide in the best way possible to promote your health. If you decide to eliminate foods permanently, get advice to be sure you make alternative dietary selections that provide you with adequate nutrition.